Gout & Alcohol: Does Alcohol Use Affect Gout?

What is Gout?

Gout is a type of inflammatory arthritis that causes extreme pain in affected joints.¹ Symptom flares can begin without warning and linger for days or weeks, and then go into remission, where you are symptom-free for long periods of time, even years.¹ Gout can affect various joints, and typically occurs in one joint at a time. It often impacts the joints in the toes, especially the big toe, but can also occur in the ankle, knee, and other joints.¹ Symptoms include:^1,2

• Pain, usually intense, that begins suddenly and often at night.
• Swelling, stiffness, redness, and warmth in the joint that is affected.

Risks & Causes of Gout

Gout occurs as a result of hyperuricemia, which means that there is an excess of uric acid within the body.¹ Uric acid is formed when the body breaks down purines, a compound found in the body as well as in food and beverages.¹ When too much uric acid builds up, it creates crystals that can collect in and around the joints, causing them to become inflamed.² There are various risk factors for developing gout. These include:^1,2,3,4,5,6

• Genetics and family history. There is a genetic component to gout, so you may be more likely to develop it if you have family members with gout.
• Gender. Males are more likely to develop gout.
• Age. Gout risk increases at mid-life, and women are more likely to develop the condition after going through menopause.
• Weight. People who are overweight are more likely to develop gout.
• Medical issues. Some health issues, such as congestive heart failure, high blood pressure, high cholesterol, insulin resistance, diabetes, kidney disease, metabolic syndrome, and osteoarthritis are associated with a higher risk of developing gout.
• Medications. Taking diuretics, low-dose aspirin, large amounts of niacin, or cyclosporine (an immunosuppressant) can increase your risk.
• Food. Eating a diet rich in purines, such as red meat, organ meat, and some kinds of seafood (anchovies, sardines, mussels, scallops, trout, and tuna) can lead to the development of gout.
• Drinks. High fructose corn syrup, as found in soda, can also increase your risk.
• Alcohol. Alcohol can increase the risk of gout, and the risk increases as your intake goes up. Beer contains high levels of purines, and drinking two beers daily can more than double your risk of developing gout, although consumption of any type of alcohol may pose additional risks. This is because alcohol increases the production of uric acid and reduces how much is removed from the body in the urine. Wine may have a considerably lower risk than beer and other alcoholic beverages as it contains additional antioxidants and other ingredients that may help mitigate the impact of alcohol on uric acid levels.

Gout is a chronic condition, so recurrent flares are common.⁵ Close to 70% of people experience at least one recurrent flare in a year.⁵ While early stages of gout can be very painful, later stages can lead to joint or organ damage, or even progress to a more severe form of arthritis.^1,2

How Does Alcohol Affect Recurrent Attacks of Gout?

Recurrent attacks of gout can be triggered by various factors.² One of the triggers is alcohol intake – especially drinking heavily or regularly.⁷ Drinking any type of alcohol can increase the likelihood of experiencing recurrent flares and episodes of gout, and heavier drinking is associated with a greater risk.^5,8 However, even drinking moderately can dramatically increase the risk of recurrent attacks, especially for men.⁸ Alcohol can also lead to increased levels of uric acid in the body even if you don’t have symptoms, which can cause increased frequency of recurrent attacks and the development of complications.^1,9

Can Quitting Alcohol Reverse Gout?

Gout affects everyone differently, and everyone’s prognosis for gout is different due to a range of individual factors, including overall health, eating habits, weight, and alcohol intake, to name a few. If you’ve been diagnosed with gout, quitting or limiting your alcohol intake, particularly beer and hard liquor, may be a good choice for you, since it has been shown to sometimes bring about flares of gout.^1,8

However, while this can eliminate a major trigger, it may not necessarily reverse gout, but it can reduce the likelihood of recurrent attacks.⁸ Overall, you should discuss your alcohol use and gout diagnosis with your doctor. Remember: a lack of symptoms doesn’t mean that gout has gone away, and damage can still be occurring within your body.⁸

How Much Can I Drink if I have Gout?

If you’ve been diagnosed with gout, this is an important discussion to have with your physician. They can provide the best guidance for you since they will know the most about your overall health and how severe your gout is. Having more than one drink in the space of a day has been shown to raise the risk of experiencing a flare of gout.⁵  If you’ve been diagnosed with gout, limiting your alcohol intake may help you prevent future gout attacks, especially if alcohol triggered a flare in the past.^7,10

Is Gout Dangerous?

Gout can lead to complications, although the progress and outlook for the condition can vary between individuals depending on a variety of factors. Many of these factors are malleable and can be effectively managed or treated with medication. While gout isn’t directly life-threatening, it can lead to other major issues, including:^1,2,11

• Infections and damage to affected joints, including deformity.
• Formation of kidney stones, chronic kidney disease, or kidney damage.
• Gouty arthritis, a type of progressive arthritis.
• Greater risk of developing heart problems.

Treatment Options for Gout

There are various medications used to treat gout, depending on the severity of your condition and other factors. While gout cannot be cured, medications can be used to:^1,4,7

• Treat flares. If you have a gout attack, nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or diclofenac, steroids, or a medication called colchicine may be prescribed to help reduce the pain and swelling. In severe cases, corticosteroid injections can be given in the affected joint.
• Lower uric acid levels. If you have many recurrent attacks, your doctor may prescribe medication to reduce your uric acid levels. These medications are taken regularly whether you have symptoms or not, and include allopurinol (Aloprim, Zyloprim), febuxostat (Uloric), and pegloticase (Krystexxa).

If you struggle to stop drinking, behavioral therapy for alcohol use disorder (AUD) or medications to help you reduce your alcohol intake can be an important part of treatment in managing gout as well. Behavioral therapies typically focus on changing patterns of thought that influence behavior, allowing you to learn healthy coping skills and recognize the stressors and other triggers that lead to drinking. They also improve your ability to communicate with others, enhance problem-solving skills, allow you to learn how to incorporate healthy activities to replace drinking, and improve motivation towards staying sober.¹³ Some of the most commonly used behavioral therapies used to treat alcohol abuse and AUD include cognitive-behavioral therapy (CBT), contingency management, motivational interviewing, community reinforcement approach (CRA), motivational enhancement therapy (MET), 12-step facilitation therapy, and family behavior therapy.¹³

Coping & Prevention Tips

Lifestyle changes can help you cope with gout and may help to prevent attacks. When you have a flare, it can be helpful to rest the affected joint, keep it elevated, and use ice on it for short periods of time.³ Staying hydrated can also help the flare pass. Managing gout involves taking steps to avoid future flares, and can include many different things, including:^1,3

• Maintaining a healthy weight. If you are overweight, losing weight can lower the risk of future flares and reduce pressure on the joints.
• Dietary changes. Staying away from foods high in purines, such as red meat, organ meat, and seafood can help you avoid triggers. Eat plenty of fruits, vegetables, and whole grains. Also, try to avoid eating a lot of fatty or sweet foods. Incorporating more low-fat dairy into your diet can help to lower the number of flares you get.
• Talk to your doctor about the medications you take. Since some medications can trigger attacks, your doctor may want you to stop them. If you are prescribed medications to lower uric acid levels, it is important to take them as prescribed even if you don’t have symptoms.
• Stay away from soda and limit your alcohol intake, particularly beer and hard liquor, which are known triggers for gout attacks. Make sure to drink sufficient water to stay hydrated.
• Moderate levels of low-impact exercise, such as walking, swimming, or riding a bicycle, can help to protect your joints and maintain a healthy weight.
• Avoid cigarettes. If you smoke, quitting is a good idea.
• Get enough vitamins. Speak to your doctor about taking vitamin C supplements.

Gout Statistics

Important gout statistics include:^3,5,11

• Gout is the most commonly occurring type of inflammatory arthritis affecting adults.
• More than 8 million adults in America have gout, although nearly 3 times as many men have it as women.
• Currently, 6.1 million men and 2.2 million women are diagnosed with gout, equivalent to 3.9% of adults in America.
• Almost 70% of people experience at least one recurrent attack yearly.
• In men, consuming 2 drinks can increase the risk of a recurrent gout flare by 41%.